Proton-pump inhibitors (PPIs) are a class of drugs with a broad range of applications worldwide. Although they have shown a very favorable safety profile, nowadays its potential for adverse effects on long-term use has caused great interest, due to the fact that the number of patients who use these drugs chronically, especially in gastroesophageal reflux disease, has increased significantly.
PPIs work by blocking the body mechanism which secretes hydrochloric acid into the stomach, known as proton pump. By this action, the improvement of symptoms in patients suffering from gastroesophageal reflux, peptic ulcer, duodenal ulcer, erosive esophagitis and Zollinger-Ellison syndrome is achieved.
Nevertheless, hydrochloric acid in the stomach plays an important role in several biological processes, so its inhibition for long periods of time can cause undesirable side effects. This situation becomes critical in patients with gastroesophageal reflux disease and Zollinger-Ellison syndrome, because PPIs are used for a very long term in these conditions. In the case of Zollinger-Ellison in particular, the use of PPIs is a lifelong and high-dose therapy.
There are basically three functions of hydrochloric acid affected when its secretion is suppressed, which are the following:    1. Help break down food into smaller molecules for subsequent absorption;    2. Aid in the absorption of some nutrients; and    3. Prevent microbial proliferation by maintaining an acidic pH, which prevents the growth of microorganisms, especially the pathogenic ones.
When the secretion of hydrochloric acid stops for a long time due to the use of PPIs, the three referred functions are altered and situations such as those listed below begin to appear:
First, there are nutrients requiring the acidic environment generated by hydrochloric acid for their absorption (calcium being the most important one). In the absence of hydrochloric acid, calcium from food and even calcium salts commonly used in dietary supplements cannot dissolve and therefore cannot be absorbed properly. The long term consequence of this malabsorption is the increased incidence of osteoporosis-related fractures.
Something similar happens with magnesium. Malabsorption of magnesium for long periods of time, which is caused by continuous use of PPIs, can cause hypomagnesemia. The consequences of hypomagnesemia may include fatigue, tetany, unsteadiness, paresthesia, seizures and cardiac arrhythmias.
Other types of nutrients require hydrochloric acid to be released from food and then absorbed. This is the case of vitamin B12 and iron. In absence of hydrochloric acid, these two important nutrients cannot be transformed into their free absorbable forms, becoming non-bioavailable. Poor absorption of iron and vitamin B12 for long periods of time can bring different undesirable effects, including anemia.
Finally, the absence of hydrochloric acid during extended periods of time favors gastrointestinal tract colonization by opportunistic pathogenic bacteria. This situation leads to events of diarrhea, esophageal candidiasis, and proliferation of Helicobacter pylori. 
From the above, it is clear that there is a need to develop a product that comprehensively replenishes all nutrient deficiencies, as well as the imbalance of the intestinal flora, caused by prolonged use of PPIs. This product should be formulated from usable components in achlorhydria (absence of hydrochloric acid) or hypochlorhydria (low amount of hydrochloric acid) found in patients under treatment with PPIs.
In this regard, if nutritional deficiencies could be supplemented and gastrointestinal flora imbalance could be corrected, the adverse effects derived from them would no arise.
In the field of patents, there EP 0904784 A1 discloses a nutritional preparation designed especially for preventing and treating gastrointestinal tract disorders, comprising viable cells of each of the following microorganisms: Enterococcus faecium, Bifidobacterium and a Lactobacillus strain that produces predominantly dextro-rotary lactate. The nutritional preparation may further comprise a number of cells of a Lactococcus strain or Micrococcus strain. Besides, the preparation preferably contains prebiotic compounds and substances that inhibit bacterial adherence to the gastrointestinal tract wall. The preparation may be in the form of a food supplement, a ready-to-use nutritional composition, an infant formula or a tube feeding.
Patent EP 1917969 A1 discloses compositions containing probiotic strains, prebiotics, vitamin complexes with oligoelements, lycopene, glutathione and possibly bioflavonoids, designed to avoid depletion of the intestinal flora and damage to organs after antibiotic treatment.
Patent application US 2012/0028914 discloses a pharmaceutical composition including PPIs and prebiotics for the comprehensive treatment of ulcer disease associated with infection by Helicobacter pylori. It discloses a pharmaceutical combination of a PPI and prebiotics to stimulate growth of lactobacilli in the upper sections of the gastrointestinal tract, including the duodenum, to significantly increase growth of lactobacilli which antagonize Helicobacter pylori. 